Permit � CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00519
DATE ISSUED: 10/21/2008
TIGARD
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4 7 ` PARCEL: 2S104AA - 12000
SITE ADDRESS: 12495 SW 129TH AVE ZONING: R - 4.5
SUBDIVISION: BELLWOOD NO. 3 LOT: 139 JURISDICTION: TIG
PROJECT: KIERNAN
Project Description: Gas fireplace insert, gas line and venting for fireplace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: 1
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
JILL KIERNAN Description Date Amount
12495 SW 129TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 10/20/20C $72.50
[TAX] 12% State Surch 10/20/20C $8.70
Total $81.20
Phone: 503 -590 -3170
Contractor:
T & K MECHANICAL
PO BOX 116
FOREST GROVE, OR 97116 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 844 -9173
FAX 503- 846 -0195
Reg #: LIC 121165
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By / _ / Permittee Signature: =
Cal 39.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
OCT -20 -2008 03 32 PM HOTSPOT 5036269138 P. 2
' � Cjtanical _ a rmit A o + Ii a l ' I. i, \. I,\ •
City at Tigard EKED 1x: :
13115 Sw He11 Slyd., Tiaara.0 p la 0.W
11 1,„... 1 Phew: 503.09.4171 Fix: 903.598.1960 OtharFermit;
r
intpcatlan Line: 903 ,039,1175 • O C T 2 0 ?O t, 1 Dnce c� lis
dyrfy: Siriaai0iaa a tar ntetnct, u Not6,t4JMahad: 1.7.C9 SnpotemntJl bforaden
1
TVP r °a- 1141,!;.,:‘ . a ' _ w, .v co RC AL rap. 9C6EDUL C�IECII�.IST1
■ ^... .... , v r , . _.
❑ New construction 1 .! Addition alto • on op coconut gorforantatl �ials the are bland to ttx •true nearest work
porft7nned. lndloeta the value (matted to the nearest dolt} of all
Demolition 0 Otitar: tneolunleal mNWrtal! equiprneat, labor overhead, Mod pot.
CATEGORY Or , CONSTRUCT/Cm /Cm Value: 5
tg 1- an mr'1,y dw
d 2•tkelting 0 Commercial/Industrial ❑ Aacssory building 3� '� 130CSP�tkI JeYSTL l81 '
Par Vide 14 dtiar tern cheakliJt
' ❑ Multi ttily ❑ Nestor truilder 0 Other; • ascription _ • sty, Ea, Total
J0):1 SITE INFORMATION AND LOCATION 4te>tttn_ soot!:
Job site address f Q CI S t la/ i A Qt.. Eigtl4RILlill - 14,00 •
Mil
C1ty /Statc/ZDP: i'? ct l , 0 r _• 7 1. Mimeos 100 000 BT .. • .. v 't � Ell
5uitolbldg 11.0.1 Project naatre: ^ t "r/ rterhAe4 f00,000* BTU (duns/you) 1 17.90
A . A Geaheat •u•.• 14.00
Croat strett/dirvstions to job sire: .t _ a o,. 10,00 MI
Rydrrggple hot water syYstem 14,00
• Raid/meal holler (radiator or
illydroala) 14,00 _
- Unit httttre (fao14yD not elotrio),
' .t' all Induct, - •:,,•,.,, 14, 4
-
g4Ndivldot+t !Milo.: Pioe/vetil for an of above r 6.80
Ott!: 10;00
Tex ma s/parool nn.: Other 13119d11}tM .
DESCRIPTION OF WORK Wow hooter 10.00
OM tiro1llaa 10.00. 1 0"
' i vve. 4 1 ' .. ` " -� Q e e.. 1 1P! . �'. v .' Flu vane for water honor or gas
iii i tiro . coat 10.00
."1; 1 • . as 11.1. 10.'4
Woodlpoliot Stove 10,00
Wood tfrollaoeyncert _ I 10.00
Chimnev/[lner /9oe/ven4 • 10.00
"..' • MUTE OWNER Cl TENANT
Other: 0.00
IMIIIIMMIK Es Irtrn • ental erohavota,ay.,,. I • .n lettatien Address: t a s .. L.J t 0 .q I NIIIIIIIIIIIII .2. , 10.00
Clty /StattIW; . ' . . e . I r . r,tr •
r : •rtr, a F I 10.00
mono: (56,3) 5 i • 3174 Pax' ( ) i�1L;Ei' ..►
1 r.• A • • !CANT d P CONTACT RSOIV a :e . _a • - „> ' 10.00 MIIIIII
/ Other • • 10.00
$6.4
� o fn. dm fours 11.00 for etch additionai
Addreur I cE ,...) i w vetiGes. L
E
°�
_Gas hoetpurnp I r
Cty/State/ZIP: U , . / . j0 I Weds /..- , endcdhutit haata'
Phone_ (g031 40 ', ( ' 4 .3.".. I hart :: (,51 (pe�� cit 3 6 Wirier heater
Tin , tau NI
CONTRACTOR rtMEIIIMIIIIIIMMI 111M 1111.11=
gueinoe!<rtelrta: t°r t Q yI -- Clothes dryor(aat)
•
Otftn;
0 w ■ .. .. 1 1 I' PUB*
Cit'/Stuel,ZfP: - -6 y _ z 1-• . • ttt . 00 { ' 7/ - . I Subtnttl _ ca •
-1 / Fnx: ) • M;ttittsan pasrad Aso (872.50
cat lie.: I Ct 1 1( r / 0 I
TOTAL Puma FEE IF
't'Me 'teppl a•onw wl epermit • emanate . ttltnI3
Authorized ali neNr 1/ dap idler to bar bets acapnd as eoropku. •
Print moo: a: An n Date: n ' gee matAodotogy get IN 7ti -Cava Palidirr h,durFry Service tared
lA ttuIWMlVxatl7Ar .OW.Pea$Apa,- •_'01/ Wit? 440.411 77 (I t/o7/031WW131)
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008.00519
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/7008
Phone: (503) 639 -4171 ha A u1wlj11i
Inspection Requests (24 Hrs.): (503) 639 -4175 j,W F '
INSPECTION WORKSHEET FOR DATE: 11/12,2008 TIME: 7:00AM PAGE: 3
SITE ADDRESS: 121195 SW 129TH AVE CLASS OF WORK:
SUBDIVISION: BELLWOOD NO. 3 LOT #: 139 TYPE OF USE:
PROJECT NAME: KIERNAN
DESCRIPTION: Gwas fireplace insert, gas line and venting for fireplace.
OWNER: KIERNAN, JILL PHONE #: 503,590 -3170
CONTRACTOR: T & K MECHANICAL PHONE #: 503.8449173
Inspection Request Scheduled For: Date: 11/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 077981 -01 503 -8411 -9130 Y
Corrections /Comments/ Instructions:
ASS n PARTIAL APPROVAL ❑ CANCEL (l NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: : . Date: i/ -- /z- - Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008 -00519
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1001/2008
Phone: (503) 639 -4171 too � � i
Inspection Requests (24 Hrs.): (503) 639 -4175 �„ !!.�i- `' ll
INSPECTION WORKSHEET FOR DATE: 11/12/2008 TIME: 7 :00AM PAGE: 2
SITE ADDRESS: 12495 SW 129TH AVE CLASS OF WORK:
SUBDIVISION: BELLWOOD NO 3 LOT #: 139 TYPE OF USE:
PROJECT NAME: KIERNAN
DESCRIPTION: Gas fireplace insert, gas line and venting for fireplace.
OWNER: KIERNAN, JILL PHONE #: 503 - 590.3170
CONTRACTOR: T & K MECHANICAL. PHONE #: 503-844-9173
Inspection Request Scheduled For: Date: 11/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 077981 -02 503 -844 -913# N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL Li NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: , / /t '� � Phone #: 503
0 // ( ) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008 -00519
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2008
Phone: (503) 639- 4171 °�i
Inspection Requests (24 Hrs.): (503) 639 -4175 '� f � l
INSPECTION WORKSHEET FOR DATE: 11/10/2008 TIME: 7:02AM PAGE: 8
SITE ADDRESS: 12495 SW 129TH AVE CLASS OF WORK:
SUBDIVISION: BELLWOOD NO. 3 LOT #: 139 TYPE OF USE:
PROJECT NAME: KIERNAN
DESCRIPTION: Gas fireplace insert, gas line and venting for fireplace.
OWNER: KIERNAN, JILL PHONE #: 503. 590.3170
CONTRACTOR: T & K MECHANICAL PHONE #: 503 - 844-13173
Inspection Request Scheduled For: Date: 11/10/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 077892 -02 503 -844 -9173 Y
Corrections /Comments/ Instructions:
/d
ia ova orua a, s ,�
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: /1– JO — Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200B- Of)619
13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: 10/21/2008
Phone: (503) 639 -4171 � �� ��I pn�p � fi ' � I I
Inspection Requests (24 Hrs.): (503) 639 -4175 !'i
INSPECTION WORKSHEET FOR DATE: 11/10/2008 TIME: 7:02AM PAGE: 9
SITE ADDRESS: 124% SW 129TH AVE CLASS OF WORK:
SUBDIVISION: BELLWOOD NO. 3 LOT #: 139 TYPE OF USE:
PROJECT NAME: KIERNAN
DESCRIPTION: Gas fireplace insert, gas line and venting for fireplace.
OWNER: KIERNAN, JILL PHONE #: 503.690 -3170
CONTRACTOR: T & K MECHANICAL PHONE #: aG3.844 -9173
Inspection Request Scheduled For: Date: 11/10/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 077892 -01 503 -844 -9173 N
Corrections /Comments/ Instructions:
1 0 A./e GCE d 5
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: A Date: /% /U —G Pi Phone #: (503) 718- �,
INSPECTOR'S SIGNATURES ARE NOT
Inspectionis Required for: / C , Iq REQUIRED ON GREEN INSPECTION CARD.
1 Code Inspection Description PASS Date By . 1. " Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ` ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG - Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG-Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in
915 Fire alarm rough -in 305 Plumbing underslab
310 Crawl drain
920 Suppression trip test
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I: \Building \Forms \InspCard- AOP- Blank.doc 02/02/07
7 t.. CITY OF TIGARD
MECHANICAL PERMIT.
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00519
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 $03.639.1171 DATE ISSUED: 10/21/2008
PARCEL: 2S 104AA -12000
SITE ADDRESS: 12495 SW 129TH AVE ZONING: R -4.5
SUBDIVISION: BELLWOOD NO. 3 LOT: 139 JURISDICTION: TIG
PROJECT: KIERNAN
Project Description: Gas fireplace insert, gas line and venting for fireplace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: 1
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
JILL KIERNAN Description Date Amount
12495 SW 129TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 10/20/20C $72.50
[TAX] 12% State Surch 10/20/20C $8.70
Total $81.20
Phone: 503 -590 -3170
Contractor:
T & K MECHANICAL
PO BOX 116
r p %
FOREST GROVE, OR 97116 REQUIRED ITEMS AND REPORTS
Contact #: PR.I 503 -844 -9173
FAX 503- 846 -0195
Reg #: LIC 121165
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
/r
Issued By / AIPP Permittee Signature: . /C
Cal "'. • 39.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•